1. Field of the Invention
The present invention relates to pharmaceutical formulations to be administered by pressurized metered dose inhalers (pMDIs) or nebulizers. The present invention also relates to processes for the preparation of such a formulation and to a pressurized metered dose inhalers or single or multidose dose vials for nebulizers filled with such a pharmaceutical formulation.
2. Discussion of the Background
Airway obstruction characterizes a number of severe respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD). Events leading to airway obstruction include edema of airway walls, increased mucous production and inflammation.
Drugs for treating respiratory diseases such as asthma and COPD are currently administered through inhalation. One of the advantages of the inhalatory route over the systemic one is the possibility of delivering the drug directly at site of action, avoiding any systemic side-effects, thus providing a more rapid clinical response and a higher therapeutic ratio.
Inhaled corticosteroids are the current maintenance therapy of choice for asthma and together with bronchodilator β2-agonists for acute symptom relief, they form the mainstay of current therapy for the disease. The current management of COPD is largely symptomatic by means of bronchodilating therapy with inhaled anticholinergics and inhaled β2-adrenoceptor agonists. However, corticosteroids do not reduce the inflammatory response in COPD as they do in asthma.
Another class of therapeutic agents which is under investigation in view of its anti-inflammatory effects for the treatment of inflammatory respiratory diseases such as asthma and COPD is represented by the inhibitors of the phosphodiesterase enzymes (PDEs), in particular of the phosphodiesterase type 4 (hereinafter referred to as PDE4).
Various compounds acting as PDE4 inhibitors have been disclosed. However, the usefulness of several PDE4 inhibitors of the first generation such as rolipram and piclamilast has been limited because of their undesirable side effects such as nausea, gastric acid secretion and emesis due to their action on PDE4 in the central nervous system and due to the action on PDE4 in parietal cells in the gut.
The cause of said side effects has been widely investigated. It has been found that PDE4 exists in two distinct forms representing different conformations, that were designated as high affinity rolipram binding site or HPDE4, especially present in the central nervous system and in parietal cells, and low affinity rolipram binding site or LPDE4 (see Jacobitz, S et al., Mol. Pharmacol., 1996, 50, 891-899, which is incorporated herein by reference in its entirety), which is found in the immune and inflammatory cells. While both forms appear to exhibit catalytic activity, they differ with respect to their sensitivity to inhibitors. In particular, compounds with higher affinity for LPDE4 appear less prone to induce side-effects such as nausea, emesis and increased gastric secretion.
The effort of targeting LPDE4 has resulted in a slight improvement in the selectivity for the second-generation PDE4 inhibitors such as cilomilast and roflumilast. However, even these compounds are not provided with a good selectivity towards LPDE4.
Compounds with selective LPDE4 inhibition activity are disclosed in WO 2009/018909, which is incorporated herein by reference in its entirety.
Additional PDE4 inhibitors having high potency are an object of the co-pending European Patent Application No. PCT/EP2010/000676 (which is incorporated herein by reference in its entirety), wherein it has been surprisingly found that the presence of sulphonamido substituents on the benzoate residue markedly improves the potency and that the (−) enantiomers are more potent than the corresponding (+) enantiomers and racemates.
Therefore, these compounds may provide significant therapeutic benefit in the treatment of respiratory diseases such as asthma and COPD, when administered by inhalation, orally or intranasally.
Thus, there remains a need for formulations for delivering such compounds orally or intranasally or by inhalation.